Research progress on the efficacy of novel oral anticoagulant for left ventricular thrombus_West China Medical Journal

Authors：

ZHANG Yuda ^1,2 , YANG Fang ^1,2 , YIN Nianpei ^1,2 ,  YANG Ying ^1,2

1. Clinical Medical College, North Sichuan Medical College, Nanchong, Sichuan 637000, P. R. China;
2. Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P. R. China;

Corresponding?author：

YANG Ying, Email: 18582547175@163.com

Keywords：

Novel oral anticoagulant; left ventricular thrombus; vitamin K antagonist; anticoagulant therapy

DOI：

10.7507/1002-0179.202410093

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Left ventricular thrombus (LVT) is a common complication of heart diseases such as myocardial infarction and heart failure. Vitamin K antagonist (VKA) is currently the main method for LVT, but its use requires frequent monitoring of coagulation indicators, which may lead to poor patient compliance. The novel oral anticoagulant (NOAC) is easy to administer and does not require monitoring of international normalized ratio or dietary restrictions. With the development of NOAC, the position of VKA for LVT may gradually be replaced in the future. This article provides a review of the comparative efficacy of NOAC and VKA for LVT in recent years, in order to provide new ideas for the clinical use of NOAC for LVT.

Citation： ZHANG Yuda, YANG Fang, YIN Nianpei, YANG Ying. Research progress on the efficacy of novel oral anticoagulant for left ventricular thrombus. West China Medical Journal, 2025, 40(4): 640-644. doi: 10.7507/1002-0179.202410093 Copy

1.	Robinson AA, Jain A, Gentry M, et al. Left ventricular thrombi after STEMI in the primary PCI era: a systematic review and meta-analysis. Int J Cardiol, 2016, 221: 554-559.
2.	Haller PM, Kazem N, Agewall S, et al. Oral anticoagulation in patients with left ventricular thrombus: a systematic review and meta-analysis. Eur Heart J Cardiovasc Pharmacother, 2024, 10(5): 444-453.
3.	黃珍珍, 饒芳, 鄧理湘, 等. 新型口服抗凝藥物與華法林治療左心室血栓的對照研究. 臨床心血管病雜志, 2024, 40(8): 661-665.
4.	Hudec S, Hutyra M, Precek J, et al. Acute myocardial infarction, intraventricular thrombus and risk of systemic embolism. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2020, 164(1): 34-42.
5.	You J, Wang X, Wu J, et al. Predictors and prognosis of left ventricular thrombus in post-myocardial infarction patients with left ventricular dysfunction after percutaneous coronary intervention. J Thorac Dis, 2018, 10(8): 4912-4922.
6.	P?ss J, Desch S, Eitel C, et al. Left ventricular thrombus formation after ST-segment-elevation myocardial infarction: insights from a cardiac magnetic resonance multicenter study. Circ Cardiovasc Imaging, 2015, 8(10): e003417.
7.	Pizzetti G, Belotti G, Margonato A, et al. Thrombolytic therapy reduces the incidence of left ventricular thrombus after anterior myocardial infarction. Relationship to vessel patency and infarct size. Eur Heart J, 1996, 17(3): 421-428.
8.	Gianstefani S, Douiri A, Delithanasis I, et al. Incidence and predictors of early left ventricular thrombus after ST-elevation myocardial infarction in the contemporary era of primary percutaneous coronary intervention. Am J Cardiol, 2014, 113(7): 1111-1116.
9.	Garber AM, Mentz RJ, Al-Khalidi HR, et al. Clinical predictors and outcomes of patients with left ventricular thrombus following ST-segment elevation myocardial infarction. J Thromb Thrombolysis, 2016, 41(3): 365-373.
10.	Feldman JM, Frishman WH, Aronow WS. Review of the etiology, diagnosis, and management of left ventricular thrombus. Cardiol Rev, 2025, 33(1): 46-48.
11.	Camaj A, Fuster V, Giustino G, et al. Left ventricular thrombus following acute myocardial infarction: JACC state-of-the-art review. J Am Coll Cardiol, 2022, 79(10): 1010-1022.
12.	Vaitkus PT, Barnathan ES. Embolic potential, prevention and management of mural thrombus complicating anterior myocardial infarction: a meta-analysis. J Am Coll Cardiol, 1993, 22(4): 1004-1009.
13.	O’Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines. J Am Coll Cardiol, 2013, 61(4): e78-e140.
14.	Ibanez B, James S, Agewall S, et al. 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J, 2018, 39(2): 119-177.
15.	Hoerbrand IA, Kraus MJ, Gruber M, et al. Favorable safety profile of NOAC therapy in patients after tricuspid transcatheter edge-to-edge repair. Clin Res Cardiol, 2024: 19.
16.	Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med, 2009, 361(12): 1139-1151.
17.	Keita I, Aubin-Auger I, Lalanne C, et al. Assessment of quality of life, satisfaction with anticoagulation therapy, and adherence to treatment in patients receiving long-course vitamin K antagonists or direct oral anticoagulants for venous thromboembolism. Patient Prefer Adherence, 2017, 11: 1625-1634.
18.	Chen A, Stecker E, A Warden B. Direct oral anticoagulant use: a practical guide to common clinical challenges. J Am Heart Assoc, 2020, 9(13): e017559.
19.	李秀芬, 葛振嶸, 帕爾哈提·吐爾遜. 利伐沙班與華法林治療左心室心尖部血栓的療效比較. 中國循環雜志, 2015(6): 559-561.
20.	Robinson AA, Trankle CR, Eubanks G, et al. Off-label use of direct oral anticoagulants compared with warfarin for left ventricular thrombi. JAMA Cardiol, 2020, 5(6): 685-692.
21.	Li S, Deng Y, Tong Y, et al. Assessment of non-vitamin K antagonist oral anticoagulants for the management of left ventricular thrombus. Clin Cardiol, 2021, 44(6): 754-760.
22.	Alcalai R, Butnaru A, Moravsky G, et al. Apixaban vs. warfarin in patients with left ventricular thrombus: a prospective multicentre randomized clinical trial. Eur Heart J Cardiovasc Pharmacother, 2022, 8(7): 660-667.
23.	黃世見. 比較不同劑量利伐沙班與華法林對左室血栓影響及其預后的研究. 長春: 吉林大學, 2022.
24.	盧輝, 迪力熱巴·肉孜, 秦順霞. 對比利伐沙班與華法林對心肌梗死后左室血栓的療效研究. 兵團醫學, 2023, 21(2): 35-37.
25.	周雙林, 杜沖, 趙勝彪, 等. 不同類型口服抗凝藥物治療急性心肌梗死后左室附壁血栓的短期療效觀察. 中西醫結合心腦血管病雜志, 2023, 21(9): 1674-1678.

1. Robinson AA, Jain A, Gentry M, et al. Left ventricular thrombi after STEMI in the primary PCI era: a systematic review and meta-analysis. Int J Cardiol, 2016, 221: 554-559.
2. Haller PM, Kazem N, Agewall S, et al. Oral anticoagulation in patients with left ventricular thrombus: a systematic review and meta-analysis. Eur Heart J Cardiovasc Pharmacother, 2024, 10(5): 444-453.
3. 黃珍珍, 饒芳, 鄧理湘, 等. 新型口服抗凝藥物與華法林治療左心室血栓的對照研究. 臨床心血管病雜志, 2024, 40(8): 661-665.
4. Hudec S, Hutyra M, Precek J, et al. Acute myocardial infarction, intraventricular thrombus and risk of systemic embolism. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2020, 164(1): 34-42.
5. You J, Wang X, Wu J, et al. Predictors and prognosis of left ventricular thrombus in post-myocardial infarction patients with left ventricular dysfunction after percutaneous coronary intervention. J Thorac Dis, 2018, 10(8): 4912-4922.
6. P?ss J, Desch S, Eitel C, et al. Left ventricular thrombus formation after ST-segment-elevation myocardial infarction: insights from a cardiac magnetic resonance multicenter study. Circ Cardiovasc Imaging, 2015, 8(10): e003417.
7. Pizzetti G, Belotti G, Margonato A, et al. Thrombolytic therapy reduces the incidence of left ventricular thrombus after anterior myocardial infarction. Relationship to vessel patency and infarct size. Eur Heart J, 1996, 17(3): 421-428.
8. Gianstefani S, Douiri A, Delithanasis I, et al. Incidence and predictors of early left ventricular thrombus after ST-elevation myocardial infarction in the contemporary era of primary percutaneous coronary intervention. Am J Cardiol, 2014, 113(7): 1111-1116.
9. Garber AM, Mentz RJ, Al-Khalidi HR, et al. Clinical predictors and outcomes of patients with left ventricular thrombus following ST-segment elevation myocardial infarction. J Thromb Thrombolysis, 2016, 41(3): 365-373.
10. Feldman JM, Frishman WH, Aronow WS. Review of the etiology, diagnosis, and management of left ventricular thrombus. Cardiol Rev, 2025, 33(1): 46-48.
11. Camaj A, Fuster V, Giustino G, et al. Left ventricular thrombus following acute myocardial infarction: JACC state-of-the-art review. J Am Coll Cardiol, 2022, 79(10): 1010-1022.
12. Vaitkus PT, Barnathan ES. Embolic potential, prevention and management of mural thrombus complicating anterior myocardial infarction: a meta-analysis. J Am Coll Cardiol, 1993, 22(4): 1004-1009.
13. O’Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines. J Am Coll Cardiol, 2013, 61(4): e78-e140.
14. Ibanez B, James S, Agewall S, et al. 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J, 2018, 39(2): 119-177.
15. Hoerbrand IA, Kraus MJ, Gruber M, et al. Favorable safety profile of NOAC therapy in patients after tricuspid transcatheter edge-to-edge repair. Clin Res Cardiol, 2024: 19.
16. Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med, 2009, 361(12): 1139-1151.
17. Keita I, Aubin-Auger I, Lalanne C, et al. Assessment of quality of life, satisfaction with anticoagulation therapy, and adherence to treatment in patients receiving long-course vitamin K antagonists or direct oral anticoagulants for venous thromboembolism. Patient Prefer Adherence, 2017, 11: 1625-1634.
18. Chen A, Stecker E, A Warden B. Direct oral anticoagulant use: a practical guide to common clinical challenges. J Am Heart Assoc, 2020, 9(13): e017559.
19. 李秀芬, 葛振嶸, 帕爾哈提·吐爾遜. 利伐沙班與華法林治療左心室心尖部血栓的療效比較. 中國循環雜志, 2015(6): 559-561.
20. Robinson AA, Trankle CR, Eubanks G, et al. Off-label use of direct oral anticoagulants compared with warfarin for left ventricular thrombi. JAMA Cardiol, 2020, 5(6): 685-692.
21. Li S, Deng Y, Tong Y, et al. Assessment of non-vitamin K antagonist oral anticoagulants for the management of left ventricular thrombus. Clin Cardiol, 2021, 44(6): 754-760.
22. Alcalai R, Butnaru A, Moravsky G, et al. Apixaban vs. warfarin in patients with left ventricular thrombus: a prospective multicentre randomized clinical trial. Eur Heart J Cardiovasc Pharmacother, 2022, 8(7): 660-667.
23. 黃世見. 比較不同劑量利伐沙班與華法林對左室血栓影響及其預后的研究. 長春: 吉林大學, 2022.
24. 盧輝, 迪力熱巴·肉孜, 秦順霞. 對比利伐沙班與華法林對心肌梗死后左室血栓的療效研究. 兵團醫學, 2023, 21(2): 35-37.
25. 周雙林, 杜沖, 趙勝彪, 等. 不同類型口服抗凝藥物治療急性心肌梗死后左室附壁血栓的短期療效觀察. 中西醫結合心腦血管病雜志, 2023, 21(9): 1674-1678.

West China Medical Journal

Research progress on the efficacy of novel oral anticoagulant for left ventricular thrombus

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content